WIP 69 - The Use of Nasal High-Frequency Jet Ventilation in a Level IV NICU

Publication Number: WIP 69.7642

Karla Ortiz, LA General Medical Center + USC, Los Angeles, CA, United States; Rangasamy Ramanathan, Cedars Sinai Guerin Children's, Los Angeles, CA, United States; Smeeta Sardesai, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States; Manoj Biniwale, Cedars Sinai Medical Canter, Los Angeles, CA, United States

Background: Extremely premature neonates are particularly susceptible to respiratory distress syndrome primarily due to surfactant deficiency, dysfunction, or inactivation, leading to broncho pulmonary dysplasia (BPD). Although intubation is lifesaving initially, it carries the potential for lung injury, prompting the need for advancements in non-invasive ventilation. Nasal high-frequency jet ventilation (nHFJV) offers a unique combination of benefits from both high-frequency ventilation and nasal intermittent positive pressure ventilation (NIPPV), providing a compelling solution for respiratory support. Currently, there is only one report in which an institution has employed nHFJV as a rescue modality for patients who remain unresponsive to NIPPV or after extubation following invasive mechanical ventilation.

Objective: To identify optimal practices for applying nHFJV in newborn infants experiencing respiratory failure. This study will evaluate the impact of successful transitions to nHFJV compared to standard neonatal respiratory support. Furthermore, it aims to analyze the various factors that influence the success or failure of transitioning from mechanical ventilation to nHFJV while also addressing any adverse events associated with the application of nHFJV as a rescue modality.

Design/Methods: This study includes a comprehensive review of all neonates admitted to a single-center Level IV NICU who experienced respiratory failure and received nHFJV from June 2024 to December 2024. The data that will be extracted from the electronic medical records include demographic information, settings in which nHFJV was applied, the duration of respiratory support, and other various neonatal outcomes. The success of using nHFJV will be defined by preventing intubation for a minimum of 72 hours after initiating this rescue ventilation technique. The collected data will be analyzed using univariate and bivariate statistics. The association of clinical characteristics such as “success” and “failure” groups will be analyzed by Fisher exact and Wilcox rank sum using IBM SPSS Statistics for Windows.